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1063155588
JACOB MICHAEL KAYLE LISTER
NEW HAVEN, CT
NPI
1063155588
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-04-14
Last Update Date
2022-04-14
Business Address
Dr. JACOB MICHAEL KAYLE LISTER MD, PHD
230 S FRONTAGE RD
NEW HAVEN, CT 06519-1124
Phone number: 203-737-7129
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Mailing Address
Dr. JACOB MICHAEL KAYLE LISTER MD, PHD
230 S FRONTAGE RD
NEW HAVEN, CT 06519-1124
Phone number: 203-737-7129
Copy
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